Books

Leaving a legacy in a role with no job description: The Gatekeepers and the Chiefs of Staff to the President

/ Jonathan Sachs

The Gatekeepers by Chris Whipple is an enjoyable read all about the role of the Chief of Staff to the President of the United States and the men (so far only men have served in the role) who have held the title.

The President’s Chief of Staff is a peculiar, non-elected and non-Senate confirmed role and its definition is wholly dependent on how the President and his Chief of Staff craft it intentionally or by inertia. The amorphous nature of the role is part of what makes it so unique and extremely personality-dependent, which gives depth to both the stories and the characters in the book.

The GatekeepersThe Gatekeepers is filled with many excellent anecdotes that give the reader an insider’s view into the workings of the White House during different administrations. For example, Donald Regan, President Reagan’s second Chief of Staff was not long for the job after hanging up on the First Lady.

Each Chief of Staff defines the job a little bit differently such as using different analogies or nicknames; a CEO and COO, Chairman of the Board and CEO, spokes of a wheel, reality therapist, heat shield, or the Secretary of S**t. But, what they all had in common was a seemingly impossible job, with no clear job description, that serves at the pleasure of the most powerful person in the country.

There are descriptions of the men who performed the job exceptionally, such as H.R. Haldeman (Nixon), Vice President Dick Cheney (Ford), James A. Baker III (Reagan and Bush 41), and Leon Panetta (Clinton). They all approached the job humbly, taking advice from many past Chiefs of Staff and studying the role. They had a plan coming in and clarified their role with the President, the Cabinet, and other advisors. Finally, they were all able to play both good cop and bad cop when needed.

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There are also descriptions of the lackluster Chiefs of Staff, such as Hamilton Jordan (Carter), Donald Regan (Reagan), and John Sununu (Bush 41). These men approached the job arrogantly, had oversized egos, couldn’t manage, some became the subject of scandal and did not generally treat people in and out of the White House well or fairly.

Other than just being an enjoyable, interesting, and provoking read, The Gatekeepers has been on my mind for two other reasons: 1) The emphasis on the structure, or lack there of, of the role and 2) The beyond-partisan bond that the Chiefs of Staff share with each other.

In my current role, I am the first full time executive leader of patient experience for our health care system. I frequently think about structure and foundation of the position in order to make sure the role is successful well beyond my tenure.

The book describes how H.R. Haldeman’s “staff system” was the foundational structure for every Chief of Staff that followed his tenure. The great Chiefs of Staff who followed like Cheney, Baker, and Panetta used Haldeman’s system as a starting point and tailored the role to the current administration from there. Haldeman also correctly identified that his main job was to protect the President’s most important asset: his time.

My goal is to create a similar approach and program that serves as a solid foundation for getting the job done today and in the future. I work tirelessly to read and research, as Haldeman did, to make sure that I am setting up patient experience at the organization for success in the future. I still have more work to do, but I believe it is critical work in starting a new function, no matter what the size or the scope of the organization.

The Chiefs of Staff are a bit like a fraternity and usually get together at the beginning of a new administration. This bi-partisan group shares wisdom with the incoming Chief of Staff and shares their experience and answers any questions. Meeting past Chiefs provides an opportunity for a new person in the role is indispensable, especially because the job description is so malleable. The humble Chiefs understand this dynamic and take the advice seriously. It seems that the current Chief of Staff can always call any of the others for guidance or advice.

Not only a great read, The Gatekeepers contains many good lessons in leadership and “followership”, helping an executive leader accomplish their goals. It is a great read for anyone interested in politics, business, or organizational development.

KEY TAKEAWAY: In a role without a real job description, relationships, structure, and adaptation are essential. Further, understanding your role in relation to a CEO when you are in the senior leadership of an organization involves humility, keeping your ego in check, and establishing and following clear rules for communication, preserving everyones most important asset: their time.

The Gatekeepers is available for purchase on Amazon for $17.00 (does not include Prime discount)

If you work with people, work on culture

/ Jonathan Sachs

In my current role as a patient experience leader for a health care system, a large part of my focus is on culture. If you are already familiar with this blog, you have already seen me discuss culture a lot in the context of leadership and in book reviews. I talk so much about culture because it is what makes systems and processes work reliably and without constant auditing.

For years, I have been working to put the pieces together in terms of how to build culture. Using ideas from authors like Simon Sinek, Malcolm Gladwell, Joseph Michelli, and Adam Grant (to name a few), I have created my own definition of leadership and have advocated for articulating a vision and creating systems and processes to bring that vision to life. However putting the pieces together both from research and experience, has at times has felt like a struggle.

Culture CodeThen along comes Daniel Coyle, author of the best-selling book The Culture Code. In this book, Coyle has compiled a clear and well explained definition around the common characteristics of organizations with exceptional cultures that lead to consistently excellent outcomes. Using examples from organizations like Pixar, the San Antonio Spurs, the famous Upright Citizens Brigade improv group, and Navy SEALs, Coyle shows us what these organizations do differently that allows them to deliver results for the enterprise and its people.

The three over-arching characteristics that every group has in common are:

  1. Build Safety
  2. Share Vulnerability
  3. Establish Purpose

Under each of these simple two-word ideas are many different anecdotes, research studies, and case studies that show not only what these concepts mean, but what building them entails for leaders.

He also delves into the nuances of these concepts that may vary depending on the business. For example, in the book he compares organizations that build a culture for high service reliability (Union Square Hospitality Group – think Shake Shack) vs. creativity and innovation (Pixar).

Health care service delivery is an example of a setting where the culture must be built for high service reliability. Much of this work involves creating genuine connections with patients and their families, which helps determine how to meet their needs both including bridging the gaps in their understanding of their condition, the treatment, the workings of a hospital, and the health care system at-large.

Coyle covers the impact of empathizing with the patients in order to the increase their health outcomes and covers how to create an environment for the staff that promotes empathic behavior.

In the book, Coyle discusses a Harvard neurologist named Marci who researched the impact of listening in the medical setting. She studied non-western healers who used methods that were scientifically questionable, yet found that some practitioners had remarkable results.

To explain these outcomes, she says, “What these healers all had in common was that they were brilliant listeners. They would sit down, take a long patient history, and really get to know their patients…They were all incredibly empathic people who were really good at connecting with people and forming trusting bonds. So that’s when I realized that the interesting part wasn’t the healing but the listening and the relationship being formed. That’s what we needed to study” (Coyle p.154).

In health care, we tend to think of communication as “provider to patient”, with the patient simply answering the provider’s questions. As I take a few steps back think about it, wouldn’t someone want to feel known as a person, and not just by a diagnosis? Just listening to the patient gives the provider an opportunity to create that relationship.

Culture in the health care setting, because of the nature of the work at times being life-or-death, is especially important. Guides like The Culture Code help us build those cultures in a safe and sustainable way.

KEY TAKEAWAY: The best companies are deliberate about building their cultures. In health care, specifically, culture can deliver superior patient outcomes if there’s a focus on the caregivers and seeing the patient as a person, rather than a diagnosis.

The Culture Code is available for purchase on Amazon for $28.00 (does not include Prime discount)

Does God exist in cyberspace?

/ Jonathan Sachs

Please enjoy this special Christmas Day blog post. Wishing you, your family, and friends a meaningful holiday full of good health and happiness.

I recently finished the book Thank You for Being Late by Thomas L. Friedman. He covers many important topics in this book including Moore’s law, global warming, and the importance of community building.

I will review the book itself in a future post, however one specific anecdote struck me in particular. Friedman describes the best audience question he has ever gotten about one of his books. During an event in Portland, Oregon in 1999, he was asked, “Is God in Cyberspace?”. Friedman writes, “I confess, I didn’t know how to answer his question, which was asked with the utmost sincerity and demanded an answer” (Friedman, 368).

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After reaching out to a mentor and scholar, Rabbi Tzvi Marx, he got his answer. Friedman explains, “In other words, he [Marx] explained, unless we bear witness to God’s presence by our own good deeds, He is not present…We are responsible for making God’s presence manifest by what we do, by the choices we make…Only we can bring Him there [cyberspace] by how we act there” (Friedman, 369).

I would argue that how we bring God anywhere, cyberspace or otherwise, is by how we conduct ourselves, especially as it relates to other people.

It reminds me of a story from the Talmud about a man who comes to see Hillel, a famous Jewish sage, to convert to Judaism. The man asks if Hillel can help him learn the entire Torah while the convert stood on one foot. Hillel said to the man, “What is hateful to you, do not do to your neighbor. That is the whole Torah; the rest is the explanation of this—go and study it!”

A core value of mine is treating people well by honoring them regardless of their experience, history or social “status”. I didn’t realize it until very recently, but that is why I studied etiquette growing up, by reading books such as How to Be a Gentleman by John Bridges and Debrett’s Guide for the Modern Gentleman. For a long time, I couldn’t explain why I read these books and why they meant so much to me. The answer, I know now, is that how we treat each other is the main way we practice basic humanity, honor ourselves, honor each other, and honor God.

It is one of the reasons I feel called to work on patient experience in the health care setting. If medical professionals can honor patients during a most difficult time in their lives, perhaps patients will pay that care forward in other places as well. Perhaps medical professionals will bring the learning to other places of employment. In other words, I think the work, if done right, could have a positive multiplier-effect.

Learning behaviors that bring honor and respect to people, such as practicing empathy, following up with a nice note, giving encouragement, and acknowledging a whole person including their feelings, hopes, desires, and wants is what underlies etiquette.

For example, in our society it is often polite to send a thank you note after being given a gift. We do this to acknowledge that the gift-giver did something nice for us and we appreciate it, showing we don’t take it for granted. It’s a beautiful process where both the gift-giver and gift-receiver feel meaning.

I find it so unfortunate that in society today, we tend to view etiquette as a stodgy, old, and obsolete way of behaving. More and more, thanks to social media and other forces, we see ourselves as the center of the universe, with others often times just in our way of being able to live the life we want (if you disagree with me, sit in DC traffic for even 20 minutes and observe your behavior and the behavior of other drivers. It is as if everyone else is just in each other’s way of getting where they want to go. Safety, fairness, and even laws feel secondary).

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Practicing etiquette to everyone is at the root of what it means to practice basic humanity and observe the golden rule. If we don’t practice, we forget. I have found it disconcerting to observe people behaving disrespectfully and rudely. It is even worse when we, as a society, glorify those behaviors in Hollywood movies or popular culture (Think “House” or the Ari character in Entourage).

During this holiday season, I have been reflecting a great deal on character and trying to lead a better life of service. Like most people, I struggle, I fall down, and I fail. But, it is my goal in 2019 to struggle a little more, while falling down and failing a little less.

One of the three main topics of this blog is “How we treat each other”. As leaders, our behavior matters so much in this area. We must focus on it and treat it more like a priority. Our behavior impacts others even more so because of our position in leadership. Giving others a positive example and creating practices that remind us all of the right ways to treat others in an imperative.

During the holiday today and as we move into 2019, please join me in reflecting on how we treat each other and what we can do to put a more positive example into the world. Please reach out to me if you have ideas or want to practice together! Please contact me here.

KEY TAKEAWAY: Leaders need to set an example and hold themselves to the highest standards around how to acknowledge and treat other people. We share this earth with 7.53 billion other people. How we get along is a main part of our humanity and how we bring a higher presence into our lives and the lives of others.